L’emergere del periurbano: il caso di Bologna

The rationale behind this piece of research is to study the movement of people from Bologna city centre to its outskirts and to find out what type of people are subject to move and the reasons for this: are they forced into or do they choose to do so? The present study will also consider how people commute from home to the city centre and the effect this has on them. For the purpose of this work, attention will be drawn to the possibility of these outer areas to develop in such a way that people will no longer need to commute to the city in order to recreate the advantages this offers to them (e.g. shops, job opportunities, ext). The theoretical framework this doctorial work is based upon concerns historical, urbanist, sociological and demographic approaches, along with the fact that the hegemony of the city centre has been benefiting has decreased. Historical centres and the central poles of metropolitan systems have lost their functional and symbolic relevance. More specifically, the Bologna Area is undergoing two tendencies: the first one is a process of residential decentralization from the capital town, capable of involving a plurality of social groups, which caused an enrichment of the social composition of "suburban" population. The second process is a partial substitution of the population in the city centre with new groups: this not only occurred with directional groups, but it has also interested new parts of the “service worker” class and members of metropolitan underclass, causing, consequentially, a growing complexity in central areas of the metropolitan system. The need to increase knowledge of Bologna territory has become more and more relevant, since the 70’s, when a series of important environmental transformations favoured a research interest that did not exclusively stopped within the city centre boarders, but rather encouraged the exploration of Bologna outer/suburban areas. Finally, in the urban/suburban discourse, this piece of research has highlighted how the search for a better quality of life (financial reasons, larger spaces, possibility to buy/rent for a better price, environmental issues) determines the choice to leave the centre of the city in favour of outer areas. The tendency that this doctorial work has brought to surface is the need to match a more manageable standard of living to the proximity to the city, despite the fact that this results in the stress caused to commuting and the lack of those cultural and entertaining facilities offered by the city. The new suburban inhabitants do not regret leaving the city, but, at the same time, do not feel emotionally attached to the new location at a community level: what they seem to look for is a more comfortable environment where to live in.

Evaluation of clinical implications correlate to genetic polymorphisms and pharmacokinetic of transdermal fentanyl

ABSTRACT Background:Strong opioids are the treatment of choice for moderate to severe cancer-related pain. Fentanyl is a synthetic opioid with high affinity for the μ-opioid receptor and is 75–100 times more potent than morphine. Fentanyl is metabolised rapidly, particularly in the liver and only 10% is excreted as intact substance. The use of CYP3A4 inhibitors and inducers, impaired liver function, and heating of the patch potentially influence fentanyl pharmacokinetics in a clinically relevant way. The influence of BMI and gender on fentanyl pharmacokinetics is questionable. Pharmacogenetic, may influence fentanyl pharmacokinetic and other factors have been studied but did not show significant and clinically relevant effects on fentanyl pharmacokinetic. Method: This is a biological interventional prospective, single-center study in 49 patients with solid or haematological neoplasm treated with transdermal fentanyl undergoing 5-step pharmacokinetic and pharmacogenetic withdrawals from administration of the fentanyl patch. Objective:to evaluate the pharmacokinetic and pharmacogenetic of transdermal fentanyl in relation to the patient's clinical response on pain Results: Sex was the only parameter with evidence of different distribution between responders and non-responders , showing a major chance for male to be responders than females. We found some correlation with pharmacokinetic parameters and sex, regarding adverse events and NRS correlation with BPI. NAT2 and UGT2B7 polymorphisms are associated with AUC and Cmax kinetics parameters, NAT2 and CYP4F2 showed some evidence of association with the fentanyl dosage and CYP2B6 polymorphism seemed to be correlate with side effects. Conclusion: Small sample size of study population make difficult do find some significant correlation between pharmacogenetic, pharmacokinetic and clinical response. Larger studies are needed to increase knowledge about response to opioid treatment in cancer patients to better individualized pain treatment.